Effectiveness of Second Life(R) in Promoting Diabetes Management ABSTRACT This application addresses broad Challenge Area (05): Comparative Effectiveness Research and specific Challenge Topic, 05-LM-104: Value of "Virtual Reality Interaction in Improving Compliance with Diabetic Regimen. The transition from adolescence to adulthood is a challenging time in diabetes self- management. As they move towards independence, young-adults with diabetes have diminishing support from families and health care providers, while simultaneously coping with changes in their housing, meal, school, work and leisure environments. The proposed study will target 18-28 year-olds, since limited research is available on how to improve their diabetes self- management skills. The proposed project will design, implement, and evaluate the effectiveness of a "Virtual Diabetes Center (VDC)" for young adults, with Type 1 and Type 2 Diabetes, using the virtual world environment Second Life(R). Second Life(R) is a virtual world where people communicate as "Avatars", computer based 3-D representations of themselves. Within Second Life(R), they navigate by walking, flying and teleporting from location to location. They use voice, text chat and visual motion and gestures to communicate with people worldwide. Initially focus groups will be conducted with current Second Life(R) users who have diabetes to determine how a VDC that promotes diabetes self-management skills should be designed. The VDC will focus on insulin, diet, physical activity, and self-efficacy. After the VDC is designed, participants with type 1 and type 2 diabetes will be recruited in Boise, Idaho, from the Humphrey's Diabetes Center. They will be randomly assigned into either a: (1) control group that receives a Face-to-Face (FTF) diabetes self-management intervention for six months or a (2) treatment group that receives a VDC diabetes self-management intervention for six months. In addition, participants in both groups will meet with health care professionals, interact with peers and attend educational sessions. Data will be collected on gender, Hemoglobin A1c, blood pressure, Body Mass Index, quality of life and self-efficacy at base line and at the end of the 6 months. The long-term goal of the project is to improve diabetes self-management among young adults with diabetes thereby diminishing the severity of diabetes complications, and improve their quality of life. The proposed study will focus on 18-28 year-olds, a group for which there is little research regarding diabetes self-management difficulties. The proposed project will design, implement, and evaluate the effectiveness of a "Virtual Diabetes Center" for young adults, with Type 1 and Type 2 Diabetes, using the virtual world environment Second Life(R).